Nutrition Education in Public Elementary and Secondary Schools

Transcription

1 NATIONAL CENTER FOR EDUCATION STATISTICS Survey Report July 1996 Nutrition Education in Public Elementary and Secondary Schools Carin Celebuski Elizabeth Farris Westat, Inc. Judi Carpenter Project Officer National Center for Education Statistics U.S. Department of Education Office of Educational Research and Improvement NCES

2 U.S. Department of Education Richard W. Riley Secretary U.S. Department of Agriculture Dan Glickman Secretary Office of Educational Research and Improvement Sharon P. Robinson Assistant Secretary Ellen Haas Under Secretary for Food, Nutrition, and Consumer Services National Center for Education Statistics Pascal D. Forgione, Jr. Commissioner Food and Consumer Service William E. Ludwig Administrator Jeanne E. Griffith Associate Commissioner Office of Analysis and Evaluation Michael E. Fishman Acting Director National Center for Education Statistics "The purpose of the Center shall be to collect, and analyze, and disseminate statistics and other data related to education in the United States and in other nations." Section 406(b) of the General Education Provisions Act, as amended (20 U.S. C. 1221e-1). July 1996 Contact: Judi Carpenter (202) This report was prepared by Westat, Inc., under contract with the National Center for Education Statistics and under a cooperative agreement with the Food and Consumer Service, U.S. Department of Agriculture.

3 Highlights Practically all public schools (99 percent) offer nutrition education somewhere within the curriculum, and many integrate it within the total curriculum (70 percent). Nutrition education is concentrated within the health curriculum (84 percent), science classes (72 percent), and school health program (68 percent) (table 1). Although nutrition education is an active area, the intensity and quality of the nutrition messages students are receiving is not known. For each grade from kindergarten through eighth, 50 percent or more of all schools have district or state requirements for students to receive nutrition education. However, only 40 percent have these requirements for ninth and tenth grades; and about 20 percent for eleventh and twelfth grades (figure 1). Topics in nutrition covered by more than 90 percent of all schools are: the relationship between diet and health, finding and choosing healthy foods, nutrients and their food sources, the Food Guide Pyramid, and the Dietary Guidelines and goals (table 4). However, with the exception of the Food Guide Pyramid, less than half of schools cover these topics thoroughly. Overall, schools focus on increasing students knowledge about what is meant by good nutrition, with less emphasis on influencing students motivation, attitudes, and eating behaviors. Four of the five topics covered by more than 90 percent of all schools are related to knowledge. With the exception of finding and choosing healthy foods, less than one-third of schools provide thorough coverage of topics related to motivation, attitudes, and eating behaviors (table 4). Research has shown that schools or districts where the nutrition education efforts are coordinated by a person or group have an opportunity to present a more focused message to students about the importance of healthy eating. However, the majority of schools (61 percent) have no nutrition education coordination, meaning each teacher is responsible for his or her own lessons (table 6). Most schools use materials developed by teachers in their schools (90 percent), health or science textbooks (89 percent), and materials developed for a specific grade level (83 percent) (table 10). Ninety-seven percent of schools report receiving nutrition lesson materials from at least one source outside the school, most often from professional or trade associations (87 percent), and the food industry (86 percent). However, for any given outside source, only 37 percent or less of schools used all or iii

4 most of the materials received. Of the materials from sources outside the school, schools reported the highest classroom usage for those received from the food industry or commodities groups, professional or trade associations, the USDA Food and Nutrition Information Center, and state education agencies (table 8). Over 90 percent of all schools offer nutrition education through the school meals program. Most information is offered through bulletin boards with nutrition displays (65 percent) or during school lunch week (51 percent). Less than half of school meals programs offer nutrient information, serve meals to correspond with classroom activities, give tours or provide nutrition input to newsletters. Less than one quarter of school meals programs provide nutrition education in the classroom or conduct tasting parties (table 11). Most respondents (84 percent) are of the opinion that the meals programs in their schools follow generally healthy eating practices (figure 5). Schools reporting that their meals programs follow healthy eating practices are substantially more likely to be involved in nutrition education activities than those that do not report following them (table 14). iv

5 Table of Contents Highlights... iii Introduction... 1 Nutrition Education in the School Curriculum... 4 Nutrition Education Topics... 7 Coordination of Nutrition Education Resources for Nutrition Education Materials Used to Teach Nutrition Sources of Materials School Meals Program Other Resources Summary and Conclusions Page List of Appendices Appendix A Survey Methodology and Data Reliability B Tables of Standard Errors C Survey Form D U.S. Public Law d Cong. 2 Nov Child Nutrition Act of Section 19(a) v

6 List of Figures Figure Page 1 Percent of public schools where nutrition is taught and where nutrition education is required, by grade: Percent of public schools where nutrition is taught and where nutrition education is required in at least one grade, by instructional level: Percent of coordinators with various highest levels of training in nutrition or a nutrition-related area: Percent of public schools that report student and parent input into the meals program, by geographic region: Percent of respondents who are of the opinion that their school meals program follows generally healthy eating practices, by instructional level: Percent of public schools that use special events for nutrition education: vi

7 List of Tables Table Page 1 Percent of public schools offering nutrition education within the school curriculum, by school characteristics: Percent of public schools where nutrition is taught, by grade and geographic region: Percent of public schools where nutrition education is required, by grade and geographic region: Percent of public schools that cover various topics in nutrition education, the percent that cover them thoroughly, and the percent for whom the topic represents a main focus of nutrition education at their school: Percent of public schools that cover various topics in nutrition education, by instructional level: Percent of public schools with various types of nutrition education coordination, by school characteristics: Percent of public schools offering nutrition education within the school curriculum, by person or group responsible for coordinating nutrition education: Percent of public schools that use various types of materials to teach nutrition education, by instructional level: Percent of public schools that receive and use materials for nutrition education from various sources: Percent of public schools that receive and use materials for nutrition education from the Cooperative Extension Service, by school characteristics: Percent of public schools where the school meals program provides nutrition education or coordinates with classroom efforts, by instructional level: Percent of public schools where the school meals program provides nutrition education or coordinates with classroom efforts, by geographic region: Percent of public schools where the school meals program solicits input through a student advisory group or pretesting new foods, by instructional level: Percent of public schools that report various meals program efforts, by whether the respondent is of the opinion that their school meals program follows generally healthy eating practices: vii

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9 Introduction The link between food and health has been well documented by numerous studies and reports describing the impact of dietary intake on disease prevention and health promotion. Dietary recommendations and long-term health objectives, including the Dietary Guidelines for Americans 1 and the Year 2000 Health Objectives for the Nation, 2 call for Americans to reduce intake of total fat, saturated fat, and cholesterol; increase intake of fruits, vegetables, grain products, and foods rich in calcium; and moderate intake of sugars, salt, and alcohol. Many Americans consume excess calories for their level of activity, and have diets inconsistent with the Dietary Guidelines for Americans- -too high in fat, sodium, and sugar, with not enough grains, fruits, and vegetables. These unhealthy eating patterns may contribute to illness and premature death in the long term. Dietary factors are associated with 5 of the 10 leading causes of death: coronary heart disease, some types of cancer, stroke, noninsulin-dependent diabetes mellitus, and atherosclerosis. 3 Because eating habits developed during childhood have the potential to last a lifetime, it is important for children to learn about the benefits of good nutrition. Therefore, the Child Nutrition Act of 1966 views nutrition education as a matter of highest priority. 4 Its importance is further addressed in Healthy People 2000, the list of health objectives developed by the U.S. Public Health Service, in which the public health community seeks, by the year 2000, to increase to at least 75 percent the proportion of the Nation s schools that provide nutrition education from preschool through 12th grade, preferably as a part of quality school health education. Education to establish healthy eating habits early in life can assure that individuals have the information and skills they need to protect and enhance their own health and the health of their families. 5 1 Dietary Guidelines for Americans. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Home and Garden Bulletin No Fourth Edition Healthy People 2000: National Health Promotion and Disease Prevention Objectives U.S. Department of Health and Human Services. Public Health Service. (PHS) Healthy People 2000, p See Appendix D, Child Nutrition Act: P.L , Sec. 19(a). 5 Healthy People 2000, p

10 The education community is also supportive of nutrition education goals. A guide for the education community, the National Education Goals in the Goals 2000: Educate America Act states that, by the year 2000, all students will have access to physical education and health education to ensure they are healthy and fit. The U.S. Department of Agriculture (USDA) actively supports these Year 2000 Goals through its School Meals Initiative for Healthy Children, 6 which promotes proper nutrition and nutrition education for children based on the Dietary Guidelines for Americans and the Food Guide Pyramid. This initiative requires schools to serve meals that meet Federal Dietary Guidelines and to teach children about nutrition so they will choose foods that are good for them. The USDA established Team Nutrition to help schools implement the new requirements in the School Meals Initiative. The mission of Team Nutrition is to improve the health and education of young people by creating innovative public and private partnerships that promote food choices for a healthful diet through media, schools, families, and the community. Team Nutrition is working toward its goals through two initiatives which include training and technical assistance to school food service personnel and adequate nutrition education for children. 7 In-school efforts emphasize the importance of nutrition education to the success of nutrition policy changes in school meals. It is not enough to change the food on the plate. We must also provide the knowledge and the skills that enable children to make choices that lead to a nutritious diet and improved health. It also is vital that local meal providers receive training on how to improve meal quality. This dual initiative to educate children and assist meal providers offers many opportunities to influence both what foods are offered by schools and what foods are eaten by children. 8 These efforts are supplemented with materials developed and distributed through partner networks and directly by USDA s Food and Consumer Service and its Cooperative State Research, Education, and Extension Service, as well as other government agencies such as the Department of Education and the Department of Health and Human Services. 6 Part of the implementation of the National School Lunch Program. 7CFR Parts 210 and Team Nutrition U.S. Department of Agriculture. 8 Federal Register, June 13,

11 This report presents the findings from the survey Nutrition Education in Public Schools, K-12 that was requested by the Food and Consumer Service of the USDA. It was designed to provide data on the status of nutrition education in U.S. public schools in order to help track current and future initiatives. The survey was conducted during the spring of 1995 through the Fast Response Survey System (FRSS) of the National Center for Education Statistics (NCES) by Westat, Inc., a research firm in Rockville, Maryland. The questionnaires were sent to 1,000 school principals of a nationally representative sample of U.S. public elementary, middle, and high schools (see Appendix A for survey methodology). The principals were asked to assign the completion of the survey to the person most knowledgeable about nutrition education at the school. Respondents were encouraged to consult with others if they were unsure of the answer to a question. The survey requested information about the following issues: The placement of nutrition education in the curriculum, The content of nutrition instruction, The coordination of nutrition education, and Resources for nutrition education. Survey findings are presented for all schools and frequently by the following school characteristics: School instructional level: elementary school; middle school; and high school. School enrollment size: small (less than 300); moderate ( ); and large (500 or more). Metropolitan status of school: city; urban fringe; town; and rural. Geographic region: Northeast; Southeast; Central; and West. Data have been weighted to national estimates of public schools. All comparative statements made in this report have been tested for statistical significance though chi-square tests or t-tests adjusted for multiple comparisons using the Bonferroni adjustment and are 3

12 significant at the.05 level or better. However, not all statistically significant comparisons have been presented. Nutrition Education in the School Curriculum Practically all public schools (99 percent) offer nutrition education somewhere within the curriculum and many integrate it within the total curriculum (70 percent ) (table 1). The most common placement is within the health curriculum (84 percent), but many schools also teach nutrition through science classes (72 percent), or through a school health program (68 percent). While this does not provide information about the intensity or quality of the nutrition messages students are receiving, it shows that the messages are being conveyed in a variety of ways within the schools. Table 1. Percent of public schools offering nutrition education within the school curriculum, by school characteristics: 1995 School characteristic Somewhere within curriculum Integrated within the total curriculum Health curriculum Science curriculum School health program Home economics curriculum All public schools Instructional level Elementary school Middle school High school Size of enrollment Small Moderate Large Metropolitan status City Urban fringe Town Rural Geographic region Northeast Southeast Central West NOTE: Respondents could report nutrition education in more than one place. SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52,

13 Given their classroom organization, elementary schools (80 percent) tend more than schools at other instructional levels to offer nutrition education integrated within the total school curriculum, although half or more of middle and high schools also reported this. High schools are most likely to place nutrition education within the health curriculum (93 percent) and the home economics curriculum (92 percent). The health curriculum is also the most common placement for nutrition education in middle schools (85 percent). Fifty-three percent of rural schools offer nutrition education through the home economics curriculum, compared with 29 percent of city schools. Nutrition is taught in each and every grade from kindergarten through tenth grade in over 90 percent of all public schools; it is taught in eleventh and twelfth grades in over 80 percent of schools (figure 1 and table 2). These statistics do not reflect the proportion of students participating at each grade level, but give a broad overview of nutrition education offerings. The percent of schools with nutrition education requirements is substantially lower at each grade level than the percent of schools that teach nutrition. For each grade from kindergarten through eighth, at least 50 percent of all schools have district or state requirements for students to receive nutrition education; 40 percent have these requirements for ninth and tenth grades; about 20 percent for eleventh and twelfth grades (figure 1 and table 3). Figure 1. Percent of public schools where nutrition is taught and where nutrition education is required, by grade: 1995 Percent Taught Required 0 K Grade SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52,

14 Table 2. Percent of public schools where nutrition is taught, by grade and geographic region: 1995 Grade All public schools Northeast Southeast Central West Kindergarten st grade nd grade rd grade th grade th grade th grade th grade th grade th grade th grade th grade th grade SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52, Table 3. Percent of public schools where nutrition education is required, by grade and geographic region: 1995 Grade All public schools Northeast Southeast Central West Kindergarten st grade nd grade rd grade th grade th grade th grade th grade th grade th grade th grade th grade th grade SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52, Among all schools, 99 percent teach nutrition in at least one of their grades, and 64 percent require nutrition education in at least one of their grades (figure 2). Substantially more elementary schools than high schools require nutrition education in at least one of their grades (68 versus 54 percent). 6

15 Figure 2. Percent of public schools where nutrition is taught and where nutrition education is required in at least one grade, by instructional level: 1995 Percent 10 Nutrition taught Nutrition education required All public schools Elementary school Instructional level Middle school High school SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52, Nutrition Education Topics Nutrition education in the classroom is intended to accomplish three important objectives. 9 The first is to convey needed information, or the facts about nutrition, so students are knowledgeable about healthy eating practices. The second is to change unhealthy attitudes so students have the motivation to establish healthy eating practices. The third is to teach positive skills so students have all the tools to accomplish their nutritional goals. The challenge is to further these objectives in ways that are age-appropriate and that respect personal and cultural preferences. The survey included a list of 17 nutrition topics that were divided into the following 3 categories: knowledge, motivation and attitudes, and behavior. 10 Respondents reported which of the topics are covered in any grade in the school, the extent of coverage (for those topics covered), and which topics represent a main focus of nutrition education at the school. Schools reported covering a wide range of topics. Each of the 17 topics are covered in the nutrition curricula of at least 60 percent of schools (table 4). Topics covered by more than 90 percent of schools, and covered thoroughly by the greatest percent, are the following: 9 Collins, Janet L., Leavy Small, M., Kann, L., Collins Pateman, B., Gold, R., and Kolbe, L., School Health Education. Journal of School Health, 65(8) (October 1995): See Appendix C, Survey Form, Question 2. 7

16 The relationship between diet and health, Finding and choosing healthy foods, Nutrients and their food sources, The Food Guide Pyramid, and Dietary guidelines and goals. Table 4. Percent of public schools that cover various topics in nutrition education, the percent that cover them thoroughly, and the percent for whom the topic represents a main focus of nutrition education at their school: 1995 Topic Covered Covered thoroughly Represents a main focus* Relationship between diet and health Finding and choosing healthy foods Nutrients and their food sources Food Guide Pyramid Dietary guidelines and goals Reading food labels Influences on food choices, such as habits, advertising, beliefs, and cultural preferences Changing eating habits (e.g., willingness to try new foods) Link between diet and diseases such as hypertension, heart disease, and cancer Interpreting nutritional information from food labels Healthy weight control Preparing healthy food Developing a personal nutrition plan Body image Signs and symptoms of eating disorders and health risks of diets, pills, binging, and purging Keeping a food diary Association between eating and stress *Schools were asked to report up to three. SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52,

17 Many topics are covered at all instructional levels. However, high schools are more likely to cover such age-appropriate topics as healthy weight control, body image, eating disorders, and the association between eating and stress; middle schools are next most likely; and elementary schools are least likely to cover these topics (table 5). Table 5. Percent of public schools that cover various topics in nutrition education, by instructional level: 1995 Topic All public schools Elementary school Middle school High school Relationship between diet and health Finding and choosing healthy foods Nutrients and their food sources Food Guide Pyramid Dietary guidelines and goals Reading food labels Influences on food choices, such as habits, advertising, beliefs, and cultural preferences Changing eating habits (e.g., willingness to try new foods) Link between diet and diseases such as hypertension, heart disease, and cancer Interpreting nutritional information from food labels Healthy weight control Preparing healthy food Developing a personal nutrition plan Body image Signs and symptoms of eating disorders and health risks of diets, pills, binging, and purging Keeping a food diary Association between eating and stress SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52,

18 Schools were asked to select the three topics that represent a main focus of nutrition education at their schools. The Food Guide Pyramid and the relationship between diet and health were each selected by 47 percent of all schools surveyed. Nutrients and their food sources were selected by 42 percent of schools, and 35 percent selected dietary guidelines and goals as part of the school s main focus (table 4). Coordination of Nutrition Education Research has shown that schools or districts where the nutrition education efforts are coordinated by a person or group have an opportunity to present a more focused message to students about the importance of healthy eating. Coordination can integrate the curriculum across grades so the nutrition lessons at each grade level build on the previous year s lessons, can integrate the nutrition messages across subjects within a grade, and can integrate classroom nutrition lessons with related nonclassroom activities. In addition, coordinators can act as repositories and resources for materials received by the school or district. Schools reported the manner in which their nutrition education efforts are coordinated by a person or group. The majority of public schools (61 percent) have no nutrition education coordination, meaning each teacher is responsible for his or her nutrition lessons (table 6). About 9 percent of the schools have one person within the school coordinating nutrition education; 24 percent coordinate using a group or committee; and about 6 percent have someone outside the school, for example from the district, coordinate nutrition education. Coordination from outside the school is more likely for elementary schools (8 percent) compared with middle schools (3 percent), and for city schools (13 percent) compared with town (3 percent) or rural schools (3 percent). A school s type of nutrition education coordination does not affect the curriculum placement of nutrition education within the school (table 7) Because of the smaller sample sizes for each type of coordination, the standard errors for these percents were large (see Table 7a in Appendix B). Therefore, the differences shown in table 7 are not statistically significant. 10

19 Table 6. Percent of public schools with various types of nutrition education coordination, by school characteristics: 1995 School characteristic One person for the whole school Several teachers, a group or committee Someone outside the school* No coordination effort All public schools Instructional level Elementary school Middle school High school Size of enrollment Small Moderate Large Metropolitan status City Urban fringe Town Rural Geographic region Northeast Southeast Central West *For example, from the district. SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52,

20 Table 7. Percent of public schools offering nutrition education within the school curriculum, by person or group responsible for coordinating nutrition education: 1995 Placement of nutrition education One person for the whole school Several teachers, a group or committee Someone outside the school* No coordination effort Integrated within the total curriculum Health curriculum Science curriculum School health program Home economics curriculum *For example, from the district. SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52, The educational background and training of the people responsible for coordination of nutrition education varies among the small number of schools that have a single coordinator on staff (figure 3). Seventy-two percent have a coordinator with a bachelor s degree or higher in nutrition or a nutrition-related area. About 61 percent have a coordinator, regardless of education level, who has completed some inservice or other training in nutrition or a nutrition-related area (not shown in a table). Figure 3. Percent of coordinators with various highest levels of training in nutrition or a nutrition-related area: % 1% 20% 2% 34% Highest training Graduate degree Bachelor's degree Associate's degree College coursework Inservice training None 38% NOTE: Based on the estimated number of public schools with a single nutrition education coordinator: 7,290 (9 percent). SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52,

21 Resources for Nutrition Education Materials Used to Teach Nutrition Nutrition education resources available to schools include not only curriculum and other lesson materials but also the school meals program, guest speakers, and assemblies and other events. All of these can be coordinated to enhance positive nutrition messages. The FRSS survey asked schools about receiving these resources and the extent to which resources received are used at their schools. Various types of materials are commonly used by schools to teach nutrition in the classroom. Most schools use materials developed by teachers in their schools (90 percent), health or science textbooks (89 percent), and materials developed for a specific grade level (83 percent) (table 8). High schools are more likely than schools at other instructional levels to use state-recommended (79 percent) or statemandated (58 percent) materials for nutrition instruction, and elementary schools (44 percent) are more likely than middle schools (33 percent) to use materials developed by a district-level curriculum coordinator (table 8). Table 8. Percent of public schools that use various types of materials to teach nutrition education, by instructional level: 1995 Type of material used All public schools Elementary school Middle school High school From external sources Developed by teachers in the school Health or science textbooks Developed for a specific grade level State-recommended State-mandated Developed by district-level curriculum coordinator SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52, Sources of Materials Many schools use packaged materials and lesson plans for nutrition instruction. Given a list of 10 outside sources, schools were asked to identify those from which they received nutrition education resources for teaching, and the extent to which the resources were used at their school. Ninety-seven percent of schools report receiving nutrition lesson materials from at least one source outside of the school, most often from professional or trade 13

22 associations (87 percent) and the food industry or commodities groups, such as the Dairy Council or the Potato Board (86 percent) (table 9). Table 9. Percent of public schools that receive and use materials for nutrition education from various sources: 1995 Source Materials received All or most materials used* All sources Professional or trade association Food industry or commodities group School library Cooperative Extension Service USDA Food and Nutrition Information Center State education agency State Nutrition Education Training (NET) Program American School Food Service Association Colleges or universities National Food Service Management Institute *Of schools that received the materials. SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52, The two Federal government sources, the Cooperative Extension Service (also known as the USDA Extension Service) and the USDA Food and Nutrition Information Center, were identified by over 60 percent of schools as sources for lesson materials and other resources. The Cooperative Extension Service has as its mission to diffuse practical information about agriculture, home economics, and rural energy. Rural schools (78 percent) and small schools (75 percent) are most likely to receive materials from this source (table 10). Because of the sample size for this survey, the effects of school size cannot be distinguished from the effects of metropolitan status through a multivariate analysis, but among all public schools in the U.S., small schools tend to be rural and rural schools tend to be small. 14

23 Table 10. Percent of public schools that receive and use materials for nutrition education from the Cooperative Extension Service, by school characteristics: 1995 School characteristic Materials received All or most materials used* All public schools Size of enrollment Small Moderate Large Metropolitan status City Urban fringe Town Rural *Of schools that received the materials. SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52, Of the materials from sources outside the school, schools reported the highest classroom usage for those received from the food industry or commodities groups, professional or trade associations, the USDA Food and Nutrition Information Service, and state education agencies (table 9). School Meals Program Healthy People 2000 states that optimally, school nutrition education should include educational cafeteria experiences as well as classroom work. 12 It appears that most schools are taking some steps toward achieving this goal. Ninety-one percent of all schools offer nutrition education for students in some way through the school meals program: 93 percent of elementary, 88 percent of middle, and 86 percent of high schools (table 11). More than half of elementary schools reported displaying nutrition information on the cafeteria bulletin board and sponsoring a school lunch week where parents eat with students and participate in other activities. Meals programs in elementary schools are more likely than those at other instructional levels to provide kitchen tours. 12 Healthy People 2000, p

24 Table 11. Percent of public schools where the school meals program provides nutrition education or coordinates with classroom efforts, by instructional level: 1995 Meals program effort All public schools Elementary school Middle school High school Any effort Bulletin board with nutrition displays School lunch week Nutrient information Serves meals to correspond with classroom activities Tours Nutrition input to newsletter Education in classroom Tasting parties SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52, Table 12. Percent of public schools where the school meals program provides nutrition education or coordinates with classroom efforts, by geographic region: 1995 Meals program effort All public schools Northeast Southeast Central West Any effort Bulletin board with nutrition displays School lunch week Nutrient information Serves meals to correspond with classroom activities Tours Nutrition input to newsletter Education in classroom Tasting parties SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52,

25 In addition to actively providing education, the meals program can support nutrition education by involving students in school menu planning and making healthy foods available at school for students to choose. About a third of all school meals programs solicit input from student advisory groups, and about 1 in 5 ask parents and students to pretest new foods (table 13 and figure 4). Table 13. Percent of public schools where the school meals program solicits input through a student advisory group or pretesting new foods, by instructional level: 1995 Type of input All public schools Elementary school Middle School High school Student advisory group provides input to the meal service School food service director has parents and students pretest new foods for the cafeteria SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52, Figure 4. Percent of public schools that report student and parent input into the meals program, by geographic region: 1995 Percent All public schools Northeast Southeast Central West Input from student advisory group to the meal service Parents and students pretest new foods for the cafeteria SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52,

26 Most respondents (84 percent) are of the opinion that their school meals programs follow generally healthy eating practices (as defined by the respondent) (figure 5). In schools where this is not the case, students can receive inconsistent messages about food choices. In addition, schools reporting that their meals programs follow healthy eating practices are substantially more likely to be involved in nutrition education activities than those that are reported as not following them. For example, 25 percent of meals programs described as healthy provide nutrition education in the classroom versus 7 percent of those not described as healthy. Those described as healthy also more often serve meals coordinated with classroom activities (51 versus 17 percent), and more often have cafeteria bulletin boards with nutrition displays (72 versus 29 percent) (table 14). Figure 5. Percent of respondents who are of the opinion that their school meals program follows generally healthy eating practices, by instructional level: 1995 Percent All public schools Elementary school Middle school High school Instructional level SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52,

27 Table 14. Percent of public schools that report various meals program efforts, by whether the respondent is of the opinion that their school meals program follows generally healthy eating practices: 1995 Meals program effort Reported following generally healthy eating practices Reported not following generally healthy eating practices Bulletin board with nutrition displays School lunch week Nutrient information Serves meals to correspond with classroom activities Tours Nutrition input to newsletter Education in classroom Tasting parties SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52, Other Resources Nutrition lessons can also be imparted through special events such as assemblies, guest speakers, or health fairs. Just about three-quarters of schools reported using special events in the past year: 63 percent used guest speakers on nutrition and 25 percent held health fairs (figure 6). Figure 6. Percent of public schools that use special events for nutrition education: 1995 Percent Guest speakers or health fairs Guest speakers Health fairs SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52,

28 Summary and Conclusions Nutrition education is important because it has the potential to improve the health and extend the lives of generations of Americans. The results of this survey indicate that nutrition education is of great interest to educators. It is offered by most public schools, is covered in many grades, and a wide range of topics are covered. However, even though nutrition education is an active area, the intensity and quality of the nutrition messages students are receiving is not known. In addition, because nutrition education is concentrated in the health curriculum, science classes, and school health programs, the proportion of students participating at each grade level is not known. There appears to be room for additional coordination of nutrition education across different subjects within the curriculum, across grade levels, and between the curriculum and the school meals program. The survey findings also indicate that schools are focusing on increasing students knowledge about what is meant by good nutrition, with less emphasis on influencing students motivation, attitudes, and eating behaviors. One objective of nutrition education is to increase knowledge. Other objectives are to change unhealthy attitudes so students have the motivation to establish healthy eating practices and teach positive skills so students have all the tools to accomplish their nutritional goals. However, less than one-third of schools that covered topics related to motivation, attitudes, or behavior provided thorough coverage of those topics. Schools use various types of materials to teach nutrition in the classroom. However, while almost all schools receive nutrition lesson materials from sources outside the school, schools do not use all or most of the materials received. Most schools use materials developed by teachers in the school and developed for a specific grade level. These results may suggest that nutrition education could benefit from development of appropriate materials, including age-appropriate materials and materials designed to assist teachers in preparing their own nutrition education lessons. There is potential for the school meals program to assume a more active role in nutrition education. Most schools are taking only some steps toward achieving the Healthy People 2000 goal of including educational cafeteria experiences as well as classroom work in school nutrition education. The majority of effort consists of displaying a bulletin board with nutrition messages, with few school meals programs offering nutrient information, providing nutrition education in the classroom, or conducting other educational activities. 20

29 Although schools or districts where the nutrition education efforts are coordinated have an opportunity to present a more focused message to students about the importance of healthy eating, most schools do not have a nutrition coordinator. A person or group with responsibility for coordination can integrate the curriculum across grades so the nutrition lessons at each grade level build on the previous year s lessons, integrate the nutrition messages across subjects within a grade, and integrate classroom nutrition lessons with related nonclassroom activities. A nutrition education coordinator can also bring a background and skills in nutrition to schools. In the schools that do have a single nutrition education coordinator, 72 percent have a bachelor s degree or higher in nutrition or a nutrition-related area. The overall findings indicate that although nutrition education is already of interest to public schools, there is room for additional effort. In particular, opportunities exist for development of appropriate materials and greater coordination across different subjects within the curriculum, across grade levels, and between the curriculum and other school resources like the school meals program so the messages received by students are consistent, pervasive, and aimed at motivating children to choose a healthy diet. 21

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31 Appendix A Survey Methodology and Data Reliability 23

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33 Survey Methodology and Data Reliability Sample Selection The sampling frame for the FRSS Nutrition Education Survey was constructed from the NCES Common Core of Data (CCD) public school universe file and included over 78,000 public elementary, middle, and high schools. Excluded from the frame were special education, vocational, and alternative/other schools, schools in the territories, and schools with the highest grade lower than grade one. Separate samples of 333 elementary, 333 middle, and 334 high schools were selected for the survey. The samples were stratified by geographic region (northeast, southeast, central, west), metropolitan status (city, urban fringe, town, rural), and school size (less than 300; 300 to 499; and 500 or more) (table A-1). Table A-1. Weighted and unweighted number of responding schools for FRSS 52, by classification variables: 1995 Unweighted Weighted Total ,956 Instructional level Elementary ,734 Middle ,485 High school ,737 Geographic region Northeast ,379 Southeast ,363 Central ,876 West ,065 Enrollment size Less than , , or more ,813 Metropolitan status City ,800 Urban fringe ,083 Town ,161 Rural ,913 SOURCE: U.S. Department of Education, National Center for Education Statistics, Fast Response Survey System, Nutrition Education in U.S. Public Schools, K-12, FRSS 52,

34 Respondents and Response Rates Sampling and Nonsampling Errors In April of 1995, questionnaires (see appendix C) were mailed to 1,000 public school principals. The principals were asked to direct the survey to the person most knowledgeable about nutrition education in the school and ask that person to complete the survey. Of the schools sampled, 12 were found to be out of scope (no longer at the same location or serving the same population), leaving 988 eligible schools in the sample. Telephone followup was initiated in mid-may and data collection was completed on July 7, with 916 respondents. The final response rate was 93 percent. Item nonresponse rates ranged from 0.0 percent to 1.0 percent. The responses were weighted to produce national estimates. The weights were designed to adjust for the variable probabilities of selection and differential nonresponse. The findings in this report are estimates based on the sample selected and, consequently, are subject to sampling variability. The survey estimates are also subject to nonsampling errors that can arise because of nonobservation (nonresponse or noncoverage) errors, errors of reporting, and errors made in the collection of the data. These errors can sometimes bias the data. Nonsampling errors may include such problems as the differences in the respondents interpretations of the meaning of the questions; memory effects; misrecording of responses; incorrect editing, coding, and data entry; differences related to the particular time the survey was conducted; or errors in data preparation. While general sampling theory can be used in part to determine how to estimate the sampling variability of a statistic, nonsampling errors are not easy to measure and, for measurement purposes, usually require that an experiment be conducted as part of the data collection procedures or that data external to the study be used. To minimize the potential for nonsampling errors, the questionnaire was pretested with knowledgeable respondents like those who completed the survey. During the design of the survey and the survey pretest, an effort was made to check for consistency of interpretation of questions and to eliminate ambiguous terms. The questionnaire and instructions were extensively reviewed by the Food and Consumer Service and the National Center for Education Statistics. Manual and machine editing of the questionnaire responses were conducted to check the data for accuracy and consistency. Cases with missing or inconsistent items were recontacted by telephone. Imputations for item nonresponse were not implemented, as item nonresponse rates were very low. Data were keyed with 100 percent verification. 26